Screening for MEN1-associated neoplasia

Slides:



Advertisements
Similar presentations
TSH SECRETING TUMORS: AN UPDATE AND THE ISRAELI EXPERIENCE Rosane Abramof Ness Sapir Medical Center.
Advertisements

Girl, 13-4/12 years old, with constitutional delay in growth and puberty. History revealed a normal growth rate but short stature at all ages. Physical.
18 F-deoxyglucose (18FDG) PET/CT fusion scan
(Modified from Hanley NA, Arlt W
Solid lines show changes in plasma glucose that occur in normal subjects in response to acute intravenous insulin administration. Note the rapid recovery.
Stage P1: Preadolescent; the vellus over the area is no further developed than that over the anterior abdominal wall (ie, no pubic hair). Stage P2: Sparse.
****Suppression of the serum TSH with levothyroxine has been shown to be of more benefit in patients with higher stages of disease. In older patients with.
Hypogonadism in aging men
(Adapted, with permission, from Fagin JA
A 48-year-old man had a 7-year history of hypertension that was not optimally controlled on four antihypertensive drugs (β-adrenergic blocker, peripheral.
A 30-year-old woman had a 7-year history of hypertension and hypokalemia. Her blood pressure was not well controlled despite a four-drug program that included.
A simplified schema for the regulation of serum phosphate by PTH, 1,25(OH)2D and fibroblast growth factor 23 (FGF23). FGF23 is produced predominantly by.
(The data are from Southard RN, et al
Hands of a patient with pseudohypoparathyroidism
(Reproduced, with permission, from Findling JW, et al
A. Relationship between serum-free thyroxine by dialysis (FT4) ng/dL and log10 TSH in euthyroid, hyperthyroid, hypothyroid, and T4-suppressed euthyroid.
This patient has a total hip bone mineral density (BMD) of 0
(Reproduced, with permission, from Gougeon A
(Reproduced, with permission, from Findling JW
This patient has a lumbar spine (L1-L4) bone mineral density (BMD) of g/cm2 (cross on the reference database graph) measured by dual-energy x-ray.
Oral contraceptive pill hormonal components
Oral contraceptive pill hormonal components
Animal model for Graves disease
bSevere or extensive disease (e. g
Serum medroxyprogesterone acetate (MPA) and estradiol levels following Lunelle injection. (Reproduced with permission from Rahimy MH, Ryan KK, Hopkins.
Various symptoms of pituitary tumor
Comparative serum steroid (CSS) levels of norelgestromin (NGMN) and ethinyl estradiol (EE) following patch administration. (Reproduced with permission.
Midsagittal section through the brain of a patient with a brain stem tumor. Histologic findings showed the tumor to be an ependymoma. Source: Discussion.
Biosynthesis and metabolism of testosterone
The stages of Reproductive Aging Workshop +10 staging system for reproductive aging in women. (Reproduced with permission from Harlow SD, Gass M, Hall.
(Reproduced, with permission, from Langman J, Sadler TW
Model of the interaction of T3 with the T3 receptor
Leptin-melanocortin system of energy balance
Epilepsy is an important predictor of poor intellectual outcome in the children with hydrocephalus with shunts. Epilepsy was significantly affected by.
Rodin, “The Kiss” (545 x 800). Accessed at
Patients exhibiting the spectrum of cleft lip and palate
Temporal patterns of headache
Approach to diagnosing pancreatic cancer
A. Magnified x-ray of index finger on fine-grain industrial film showing classic subperiosteal resorption in a patient with severe primary hyperparathyroidism.
Illustration of ways regression lines can differ
One theory of the pathogenesis of Graves disease
Proposed pathogenesis of Graves disease
A standard epidural order form.
Total infralevator exenteration
A 48-year-old man had a 7-year history of hypertension that was not optimally controlled on four antihypertensive drugs (β-adrenergic blocker, peripheral.
Diagrammatic representation of the mechanism of action of testosterone on target cells. Testosterone (T) circulates in association with sex hormone–binding.
Metabolism of chylomicrons
Potential hormonal mediators of amenorrhea
As is shown, men treated by radical prostatectomy had a better adjusted survival rate than men without prostate cancer suggesting selection biases for.
A. Central B-cell tolerance: As T cells do in the thymus, B-cells rearrange their B-cell receptor (BCR) in the bone marrow. Unproductive rearrangements.
Temporal patterns of headache
Sonographic patterns and risk of malignancy. A
Adjusting probabilities with new information and treatment thresholds
(Modified from Conlin PR, et al
The processing of microRNA that is involved in gene regulation by RNA interference. (Reprinted with permission from Brooker RJ: Genetics: Analysis & Principles,
Schema of the two zinc fingers, together with coordinated zinc ion, which make up the DNA-binding domain of the glucocorticoid receptor (amino acids are.
Model for the histological and genetic progression from normal cells (far left) through pancreatic intraepithelial neoplasia (PanIN) lesions (center),
Longitudinal effects of aging on date-adjusted testosterone (T) and free testosterone index (free T index). Linear segment plots for total T and free T.
Hypogonadism in aging men
Epigastric hernia. Note closeness to ­midline and the presence in upper abdomen. The herniation is through the linea alba. Source: Hernias & Other Lesions.
An algorithm for women who have developed secondary sexual characteristics, have experienced menarche, and are presenting with amenorrhea or oligomenorrhea.
Renin-angiotensin-aldosterone and potassium-aldosterone feedback loops
Responses of serum insulin to selective intra-arterial calcium stimulation in a patient with biochemical confirmation of inappropriate hyperinsulinism.
Number of uninsured persons in the United States, 1980 to 2014 (U. S
(Reproduced, with permission, from Fulop M, et al
Compound heterozygosity at two different loci in hereditary hearing loss. (a) Autosomal recessive hearing loss due to mutations in the gene connexin 26.
The “windshield wiper test” (passive internal and external hip rotation in 90 degrees of flexion). Pain and stiffness suggest hip joint arthritis. Source:
Hypothalamic-pituitary-thyroid axis
Copyright © 2004 The McGraw-Hill Companies, Inc. All rights reserved.
Copyright © 2004 The McGraw-Hill Companies, Inc. All rights reserved.
Presentation transcript:

Screening for MEN1-associated neoplasia Screening for MEN1-associated neoplasia. Testing is targeted to individuals who either harbor the MEN1 gene or have a high probability of harboring the MEN1 gene (eg, first-degree relatives of affected kindred members). If genetic testing is available and the specific mutation has been confirmed, screening for endocrine neoplasia would be limited to those individuals harboring the defective gene. Screening for other pancreatic (eg, insulinomas) or pituitary tumors (eg, somatotroph adenomas) is based on the prevalence of the specific lesion in the affected kindred or the presence of signs or symptoms suggesting a particular lesion (IGF, insulin-like growth factor). Source: Multiple Endocrine Neoplasia, Greenspan's Basic & Clinical Endocrinology, 10e Citation: Gardner DG, Shoback D. Greenspan's Basic & Clinical Endocrinology, 10e; 2017 Available at: http://accessmedicine.mhmedical.com/DownloadImage.aspx?image=/data/books/2178/gardgreen10_ch22_f003-1.png&sec=166253573&BookID=2178&ChapterSecID=166253542&imagename= Accessed: November 15, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved